Tuberculous spondylitis as a cause of inflammatory spinal pain: a report of 4 cases

Patients are said to have inflammatory spinal pain if they
fulfill at presentation 4 of the following 5 criteria:
duration of spinal discomfort for at least 3 months, spinal
morning stiffness, age less than 40, insidious onset of
symptoms, and no relief from pain with rest, but improvement
with exercise. Inflammatory spinal pain is typical of the
spondylarthropathies. Only in a minority of the cases it is
found in other rheumatic disorders such as rheumatoid
arthritis, fibromyalgia or infectious spondyilitis.
Tuberculous spondylitis is rarely mentioned as a possible
cause of inflammatory spinal pain. We describe 4 patients with
tuberculous spondylitis seen over a 3-year period who met the
clinical criteria for inflammatory spinal pain at
presentation. We conclude that inflammatory spinal pain may be
a presenting feature, albeit rare, of tuberculous spondylitis.
Awareness of this finding should help facilitate the proper
diagnosis and the institution of appropriate therapy.